Saturday, December 5, 2009

The Enuresis Alarm Treatment Plan

1- Obtain the alarm

Once you have obtained an enuresis alarm, follow the instruction included with the device.


2- Test the alarm.

To test an alarm, pinch the moisture sensor between your fingertips. The alarm should sound. If it doesn't, check the batteries. Also, some devices have a plastic tab inserted by the manufacturer in order to prevent discharge of the batteries. In order for the device to sound, you must pull the plastic tab out.


3- Attach the alarm.

You should attach the alarm's motion sensor to your child's underpants. Carefully place the sensor where the child's urine is likely to damper it, for girls attach it low on the front panel of the underpants, for boys, it should go slightly higher.

In using the alarm, watch out for any shearing of the wire at its junction with the alarm box. If your child is rough, consider putting a piece of electrical tape over this spot to reinforce the connection.


The Alarm Schedule


Its is very important for your child to wear the enuretic alarm consistently. In order for the alarm to be effective, your child should simply with the following schedule:


Step 1- The child should wear the alarm every night until he has fourteen consecutive dry days and nights.


Step 2- After fourteen days and nights of dryness, the child may wear the alarm every other night for two weeks.


If the child wets no more than once during this 2 week period, go on to step 3.

If the child has more than one wet night in the two week period, immediately return to step 1 and repeat the process.


Step 3- The child may now wear the alarm every third night for two weeks.

If the child wets no more than once during this two weeks period, go on to step 4.

If the child has more than one wet night in the two week period immediately return to step 1 and repeat the process.


Step 4- The child may now wear the alarm every four night for two weeks.

If the child has no more than one wet night in the two week period, go on to step 5.

If the child has more than one wet night in the two week period, immediately return to step 1 and repeat the process.


Step 5 Discontinue using the alarm. Taper off from the others concurrent treatments. See finishing up for more info.

Many families we see in our practices are so frustrated with their child's wetting problem that just starting the alarm treatment for them is like seeing the light at the end of a dark tunnel. We tell them to expect their child to begin having dry nights after using the enuresis alarm and the accompanying treatments in one month time, then continuing the treatment should lead to dryness.

If, on the other hand, their child shows no progress in one month, they should talk to their doctor and fine tune the program. (It is also possible that your child has not shown dryness because he is experiencing incontinence, not enuresis.) To help parents get past any reluctance they may have about the amount of work involved in this treatment, we stress that this first month is a trail period. Taking the program one step at a time will improve everyone's outlook, reduce he level of stress associated with wetting, and increase your child's chances for success.


Tips And Advise



In this section, we offer some tips involving alarm use that you should consider in the light of your day, as you prepare for the sounding of the alarm at night.


You and you spouse need to agree in advance which one of you will get up with the child each night.

Ideally, the enuresis alarm would rouse the sleeping child, he would get up and urinate in the potty and then return to bed, all with out assistance. In reality, very often a child who wets sleeps too deeply to respond to the alarm. So, it falls to the parents or other adult family members to listen for the alarm as a sentry during their sleep and, when it does go off, to get up and help the child to the potty. If possible, arrange to alternate turns with your spouse, so that each of you can at least get a good night's sleep every other night.


Avoid asking an older sibling to assume responsibility for getting up with the child at night.

Whenever is possible, arrange to be home when your child is wearing the alarm at night. It is a parent's responsibility to manage the child's treatment. A sibling who is made to stand in front for a parent could come to resent his or her brother or sister for wetting, as well as the parents for not taking charge. Also, by following through on your commitment to help your child stop wetting, you send a powerful message to all your children.


The child should sleep in a room near your bedroom, if possible, to make it easier for you to hear and respond to the alarm.

Because you will probably be getting up with your child, it is a good idea to have your rooms close together. As we have seen, most children with enuresis are deep sleepers. The sound of the enuresis alarm will most likely wake you before it wakes your child, at least in the beginning. When the alarm goes off, you need to be close enough to hear it and get to your child quickly to lead him to the toilet before his bladder is completely empty. Note, though , that the child should not sleep in the same room as you, doing so can reinforce the wetting problem, since most children can become dependent on sleeping near a parent, which may end up harming a child's self concept, particularly if the child sees himself been immature.

If possible or impractical to be nearby, consider using a baby monitor or an intercom, which will enable you to hear what is going on in your child's room. With this arrangement, when the alarm sounds you will be able to hear it easily. If a sibling must move out of his or her bedroom so the child that wet can be closer to you, explain to the displaced brother or sister that this is a temporary arrangement and that he or she will move back when the enuretic child is dry.


If possible, have your child sleep in the bedroom closest to the bathroom.

The shorter the distance your child has to travel at night, the better the chance that she will make it in time to complete her urination. It is also safer if she does not have to walk very far in a sleep condition.


Make sure the route to the bathroom is clear of toys and other obstacles and is also adequately lit with night lights.

There are a variety of inexpensive night lights that plug into electrical sockets and are bright enough to illuminate a path with out keeping anyone awake. Some models turn themselves on when the natural lighting is dim and turn off when the room in brighten, so that you can keep them plugged in all day. Putting a night light is nice, too, so that the child does not have to face harsh, bright lights when she gets up to urine.


Make sure your child's room, or at least his bed stays comfortably warm through the night.

Since your child will continue to wet while learning to improve his bladder control, it is a good idea to keep fresh bed sheets, pajamas, and underwear in the child's room. In fact because many children wet more then once at night, having two or more sets of bedding and clothing at hand is advisable. Also, as long as your child is comfortable with the idea, consider putting a hamper or a basket in the child's room to receive the soiled laundry. If the child wants to keep her wetting private, she can remove the hamper from her room when she's expecting visitors.


Be sure that your child follows a similar alarm procedure wherever he sleeps.

In families with multiple households, because of divorce or other reason, the child must take his alarm with him or have an additional alarm at his other home. Continuity is key to becoming dry. Similarly, if your child routinely sleeps at his grandparents house, make sure that everyone understands the alarm procedure.

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